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Accelify Blog

Turning Transportation Services into Medicaid Revenue

June 17, 2014

How schools can take advantage of this valuable revenue source.

In 1975, the United States Government enacted the Individuals with Disabilities Education Act (IDEA) to ensure “a free and appropriate education” for all children with disabilities. IDEA mandates that children with disabilities receive all the special education services and other related services necessary to participate in standard educational classrooms, which means schools districts are required to provide the necessary services, such as speech therapy or physical therapy, to students with disabilities. Today, 57% of students with disabilities are in general education classrooms for 80% or more of the day, and 6.7 million children and youths receive special education and related services. Without the proper systems in place, managing IDEA can be costly for schools districts, but it doesn’t have to be. Many of the health-related services provided to students with disabilities are reimbursable by Medicaid, and in most states, the cost for transportation to bring the student to and from those services is also reimbursable.School districts are entitled to Medicaid funds for providing health-related services under three distinct programs: Fee-for Service (FFS), School District Administrative Claiming (SDAC), and Cost Reconciliation (CR). Transportation typically falls under the FFS program, which covers services rendered to students under their Individualized Education Plan (IEP). In some states, like Kansas, transportation is claimed through the cost reconciliation process, which covers the actual Medicaid allowable costs for providing health-related services, including transportation. For a fully maximized program, where all services are being documented, districts can expect to receive $400‐$700 per Medicaid eligible student with an IEP, with transportation claiming usually totaling about 10-15% of overall FFS claims. A good estimator is that district’s average +/- $40 – $100 per IEP student/year.

In order to claim for transportation services, there are a few criteria that must first be met. Nationwide, transportation services can only be claimed if transportation is an authorized service in a student’s IEP. The student also needs to have received an IEP authorized direct health service on the day that transportation services were provided and that service has to be claimed and paid. In addition, when doing any FFS claiming, only services provided to Medicaid-eligible students are eligible for reimbursement and the district must have parental consent to bill Medicaid. Due to the work involved in gathering and manipulating data in order to verify those items, even in school districts where health services are being claimed under the FFS program, districts often leave potential reimbursement for transportation unclaimed.

Accelify’s AcceliROUTE system was designed with those items in mind, and was created to simplify the entire student transportation management and billing process. Beyond verifying Medicaid eligibility, which Accelify runs once a month, and tracking parental consent, AcceliROUTE tackles the other two biggest challenges a district claiming transportation can face – tracking ridership data and matching trips to paid services. The system allows administrators to build or import bus routes, with the ability to enter transportation services manually or using Accelify’s AcceliSCAN technology to simply scan bus logs for automatic data processing. No matter what the school district’s current situation is AcceliROUTE can do the job for the district.

For districts with a routing system in place (like Edulog) but without ridership tracking, Accelify can integrate with the routing system and implement the AcceliROUTE scanning solution; for districts tracking ridership information in a third-party system like Zonar’s ZPass and choose to use our service tracking system to track health services, we can import the ridership information, and conduct the validations and health service matching to create claims; and for districts tracking ridership information in a third-party system like Zonar’s ZPass and also managing Medicaid billing in an outside system, we can import all that information and conduct the validations to build transportation claims. In addition to taking care of the two major challenges of transportation claiming, tracking ridership and matching trip dates to paid health services, Accelify also ensures that documentation is audit proof by tracking eligibility, proper IEP documentation, and all other validations within our system.

Accelify has implemented and managed efficient, compliant and successful Medicaid reimbursement programs for transportation in multiple states for more than a decade (Florida, Virginia, DC, Wisconsin, Texas, California, Missouri, and Illinois). Our clients have usually processed claims in 30-90 days and received significant dollars within 3-4 months, and they’ve never had to return Medicaid funds due to an audit finding. With our years of experience in Medicaid claiming and our flexibility in implementing programs, Accelify is equipped to face any challenges involved with implementing a transportation program for large and small districts nationwide.